Macarenco Ricardo S, Filippi Renee Z, D'Almeida Costa Felipe, Jesus-Garcia Reynaldo
Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil.
J Cutan Pathol. 2018 Feb;45(2):141-145. doi: 10.1111/cup.13062. Epub 2017 Nov 27.
The great saphenous vein (GSV) corresponds to the main superficial large-caliber vessel affected by leiomyosarcoma (LMS). Given its superficial location and because signs of vascular origin may not be clinically apparent, LMS of the GSV may be misinterpreted clinically as superficial nonvascular soft tissue mass. Herein, we report a case on the distal portion of the right GSV of a 57-year-old man. The histopathological recognition of a large-caliber vein-associated LMS (with granular cell change) in an incisional biopsy specimen was crucial to guide radiological evaluation and confirmation of a superficial vascular LMS before surgical treatment. Recognizing this entity in small biopsies is important as its surgical treatment and prognosis differ substantially from nonvascular superficial (ie, subcutaneous and dermal) LMSs. In addition, because vascular LMSs can involve long vessel segments, underestimation of extent of disease is a risk. To the best of our knowledge, granular cell change has not been documented in LMS of the GSV.
大隐静脉（GSV）是受平滑肌肉瘤（LMS）影响的主要浅表大口径血管。鉴于其浅表位置，且血管起源的体征在临床上可能不明显，GSV的LMS在临床上可能会被误诊为浅表非血管性软组织肿块。在此，我们报告一例57岁男性右侧GSV远端的病例。在切开活检标本中对大口径静脉相关LMS（伴有颗粒细胞改变）进行组织病理学识别，对于在手术治疗前指导放射学评估和确认浅表血管性LMS至关重要。在小活检中识别这种实体很重要，因为其手术治疗和预后与非血管性浅表（即皮下和真皮）LMS有很大不同。此外，由于血管性LMS可累及较长的血管段，存在低估疾病范围的风险。据我们所知，GSV的LMS中尚未记录有颗粒细胞改变。
